Drug dependence and death: Survival analysis of the Baltimore ECA sample from 1981 to 1995

Aims: Illicit drug use and dependence often are associated with premature death, but available evidence comes mainly from clinical samples. The present paper examines drug-related mortality experience over 14 years in a United States community sample. Participants: Following probability sampling, 3,481 adult community household residents were recruited for the 1981 NIMH Baltimore Epidemiologic Catchment Area survey. Follow-up occurred in 1993-1996 Methods: Survival analyses were used to estimate median age at death and relative risk of dying in relation to drug use and dependence as assessed in 1981 using the Diagnostic Interview Schedule (DIS). Findings: Cases with DIS "drug dependence" were more likely to have died and to have a younger median age at death (p < .05), with and without statistical adjustment for confounding variables. Higher levels of drug involvement also were associated with increased age-adjusted mortality. Conclusions: The evidence favors the hypothesis that DIS-elicited "drug dependence." as well as subthreshold drug use, help to account thr premature death in this community sample.